The effect of fecal microbial transplant on intestinal microbial composition in short‐bowel neonatal piglets

Abstract

Background Short‐bowel syndrome (SBS) in neonates is associated with microbial dysbiosis due to intestinal surgery, prolonged hospitalization, enteral nutrition, and repeated antibiotic exposure. Sepsis and liver disease, leading causes of morbidity and mortality in SBS, may relate to such intestinal dysbiosis. We investigated the safety and feasibility of fecal microbial transplant (FMT) to alter intestinal microbial composition in SBS piglets. Methods Following a 75% distal small‐intestinal resection, piglets were fed parenteral nutrition with an elemental diet and randomized to saline (SAL; n = 12) or FMT (n = 12) treatments delivered by gastric tube on day 2 (d2). The FMT donor was a healthy adult pig. Comparisons were also made to healthy sow‐fed littermate controls (SOW; n = 6). Stool samples were collected daily, and tissue samples were collected at baseline and termination. Microbial DNA was extracted from stool and analyzed using 16S ribosomal RNA sequencing. Results All piglets survived to the end point. On d2–d4, FMT piglets had some differences in microbiota composition compared with SAL, SOW, and donor counterparts. Between base and term, there were transitory changes to alpha and beta diversity in FMT and SAL. Conclusion FMT treatment in postsurgical neonatal piglets with SBS appears safe, with no increase in sepsis and no mortality. In SBS piglets, FMT induced transient changes to the intestinal microbiota. However, these changes did not persist long‐term.

Fecal microbiota transplantation in a rodent model of short bowel syndrome: A therapeutic approach?

“…one week after the FMT, may be considered as a limit of this experiment. A recent study reported that FMT on SBS piglets induced only transient changes to their intestinal microbiota that did not persist after 5 days (Hinchliffe et al, 2022). Furthermore, colonization by a "dysbiotic" microbiota from animals on HFD is transient if the diet is not maintained (Tomas et al, 2016).…”

Impact of Total Parenteral Nutrition on Gut Microbiota in Pediatric Population Suffering Intestinal Disorders

“…Finally, the resolution of these challenges and questions will allow us to design individualized strategies which are focused on the gut microbiota’s composition and function for the prevention of TPN-related gastrointestinal diseases in the pediatric population, improving their clinical outcomes when long-term PN is required. In this regard, for instance, there are still many challenges regarding the safety and effectiveness of a fecal microbiome transplant in order to restore the gut microbiota in humans, although promising short-term clinical outcomes have been obtained in animal models of SBS fed with PN [ 211 ]. Interestingly, this new knowledge must be considered in updated guidelines in order to strongly recommend the use of prebiotics, probiotics, synbiotics, postbiotics and paraprobiotics as an adjunctive therapy in the prevention and treatment of PN-related diseases.…”

Current therapy option for necrotizing enterocolitis: Practicalities and challenge

“…Rectal administration is the most preferable method of administering FMT, since oral FMT administration increases lethal sepsis incidence and overall mortality by exposing the proximal gut to potentially pathogenic organisms ( 66 ). However, according to another study, intragastric administration of FMT appears safe in postsurgical newborn piglets with SBS, with no sepsis and no mortality ( 67 ). Hence, there is a need to further explore the security of administration of FMT by different routes.…”